licence transfer application form step 1: guidancethe certificate shall be retained by the public...
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Licence Transfer Application Form
Step 1: Guidance
Current Licensee
Contact Name Simon Garrett
Contact Position EHS&S Senior Manager
Date 10/01/2017
Proposed Transferee
Contact Name Liam Nagle
Contact Position EHS Specialist
Date 14/11/2017
Licence Transfer Application Report - P0016-02 Page 1 of 22
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Step 2: Current Licensee
Licence Reg No P0016-02
Licensee Janssen Pharmaceutical
Licence County Cork
Site Location Wallingstown, Little Island, Cork
ELRA / CRAMP Review
Provide additional information on ELRA / CRAMPThe ELRA and CRAMP have been submitted to the EPA for approval.The EPA are currently reviewing hte ELRA and the CRAMP.
Request ELRA / CRAMP Status? ELRA/CRAMP Approved
Contact Information
Proposed Transferee Organisation Janssen Pharmaceutical Sciences UC
Proposed Transferee Contact Email [email protected]
Reason for licence transfer request
The transfer is requested due to a legal entity change. This is resulting in a name change but also a CRO number change. The transfer is requested to transfer the licence and all liabilities to the new entity.
Desired date for proposed transfer to take effect 18/11/2017
Confirm Enforcement Charges Paid Yes
Specify Outstanding Enforcement Charges €0.00
Additional Information
Additional Information Please find attached the EPA licence along with amendments A an B.
Licence Transfer Application Report - P0016-02 Page 2 of 22
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Step 3: Proposed Transferee
Name Janssen Pharmaceutical Sciences UC
Address Little Island Industrial Estate, Little Island, T45 P663, Cork
Transfer Contact Liam Nagle
Additional Transfer Contacts
Name Position Home Phone Mobile Phone Email
General Background
Business Activity The production of pharmaceutical products including intermediates.
Date Established 02/01/2017
Total Assets Value €
Turnover €
Profit €
State whether your organisation is a Holding Company No
Fit and Proper Person Checks
Environmental Protection Agency Act 1992 as amended? No
Waste Management Act 1996 as amended? No
Local Government Acts 1977 and 1990 or Air Pollution Act 1987? No
Management and Supervisory Details
Name Details of Relevant Education, Training and Experience Responsibilities
Pat Fitzgerald Degree and Masters in Science/Engineering subjects. EHS Manager
Kyran Johnson Degree Qualified General Manager
Licence Transfer Application Report - P0016-02 Page 3 of 22
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Licence Application History
Has the Proposed Transferee, their parent company or any relevant person had an application for a licence...
Granted? No
Rejected? No
Revoked? No
Transfer Refused? No
Additional Information
Financial Provision in place? Yes
Additional Information
Licence Transfer Application Report - P0016-02 Page 4 of 22
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Step 4: Fees, Declaration and Submit
Payment Amount €2,000
Payment Method EFT
Payment Date 24/11/2017
Application Submission Date 17/11/2017
Licence Transfer Application Report - P0016-02 Page 5 of 22
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Short Certificate of Incorporation of a Company (Electronic Form, for Public Service Use only)
I hereby certify
Certified by me at Dublin, this Thursday, the 16th day of November, 2017.
( )69662F
Registrar of Companies
I make this Declaration for the benefit of
(name of public body) __________________________________________________
to whom I am furnishing the Certificate.
__________________ _______________________Signature of Applicant Date Forgery Act 1913, section 4 and 6
hereby declare that this is one and the same as the Certificate of Incorporation of the above company that was made available electronically, for public service use, at my request, by the registrar of companies. I further declare that to the best of my knowledge, information and belief, the said Certificate has not been altered or amended in any way. I acknowledge that it is a criminal offence to forge a public document with intent to defraud or deceive, and that it is an offence to utter a forged document with intent to defraud or deceive, in each case punishable with imprisonment for a term not exceding two years.
I, (name)of (address)
NoteThe above certificate of incorporation is furnished free of charge by the registrar of companies and is valid solely for public service use. A process has been put in place whereby, where necessary, the certificate may be verified by a public service body on inquiry to the registrar.
The applicant for any public service who is required to produce a certificate of incorporation must certify below that the certificate has not been tampered with in any way. The certificate shall be retained by the public service organisation that requires its delivery and may be used as evidence of any wrongful use.
Companies Act 2014, section 216; Electronic Commerce Act 2000, sections 12 and 13
Tuesday, the 24th day of November, 2015.
572261that company number
as a Unlimited Company on
JANSSEN PHARMACEUTICAL SCIENCES UNLIMITED COMPANY
was Incorporated under the Companies Act 2014
Licence Transfer Application Report - P0016-02 Page 19 of 22
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